Individual
MADHAVA S RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 MULBERRY ST, SCRANTON, PA 18510-2369
(570) 703-4830
(570) 703-4835
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD022769E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000783324
—
PA
01
—
157430
BLUE SHIELD
PA
Enumeration date
10/27/2005
Last updated
07/17/2020
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